Now that spring is officially here, itís time to start thinking about enjoying more of the great outdoors. Picture yourself walking across the uneven lawn while you visit with a friend and carry your lunch to the picnic table. Are you confident in your balance? Does your fear of falling limit your social interactions? If so, it is important to know that this is not a normal part of aging and you can improve your balance.

Just about everything you do in your daily life, whether for work or leisure requires balance control, and most of the time you donít have to think about it. The ability to maintain balance is a complex process that depends on three major components: (1) your sensory systems for accurate information about your bodyís position relative to your environment; (2) your brainís ability to process this information; and (3) your muscles and joints for coordinating the movements required to maintain balance.

The sensory systems include your sense of touch (feet, ankles, joints), your vision and your inner ear motion sensors. For example, our feet and joints tell us if the surface we are standing on is uneven or moving, such as when riding an escalator. We rely on our eyes to tell us our body position relative to the world around us. And our inner ears tell us if we are upright, leaning, standing still or moving.

Your brain controls balance by using the information that is most important for a particular situation. For example, at night, when itís dark and the information from your eyes is reduced, your brain will use more information from your legs and your inner ear. Many people rely heavily on their vision for balance and the other systems get out of practice. This might explain why you need to hold onto furniture and slow down when getting up in the middle of the night.

Another example is when you are walking on a sandy beach or walking up a ramp during the day, the information coming from your legs and feet will be less reliable and your brain will use information from your vision and inner ear more.

Balance is a complex coordination of all of these systems in the body. Injury to one or more of these systems may cause you to lose your balance or stumble. The good news is that research supports the use of specific exercises to retrain your balance. Common exercises that may help improve balance are walking and practicing getting up from a chair.

Before trying any new exercises, speak to your physician.

By understanding which systems are impaired, you can engage in exercises to build confidence, reduce fear of falling and minimize falls. If you or someone you know is having balance problems or falls, it is important to make an appointment with your physician as there are many medical factors that can contribute to poor balance. A physical therapy evaluation can help determine the specific problem related to your balance and a personalized program can be created to improve balance, confidence and safety.

Page 2 of 2 - Kate Gebski, PT, MSPT, NCS is a physical therapist at Spaulding Outpatient Framingham (Mass.). She is a graduate of Boston University with more than 12 years of clinical experience with special interest in neurological disorders and balance disorders. Rhonda Salvo, PT is an advanced physical therapist at Spaulding Outpatient Center Framingham. She is a graduate of Northeastern University with 23 years of clinical experience with special interests in both orthopedic and neurological populations.